Bladder Irrigation Time Research Articles

Analysis of clinical efficacy of transurethral plasmakinetic resection of prostate combined with pneumatic lithotripsy in the treatment of benign prostatic hyperplasia and bladder stones

Objective To analyse the clinical efficacy and adverse reactions of transurethral plasmakinetic resection of prostate(PKRP) combined with pneumatic lithotripsy(TULT) in the treatment of benign prostatic hyperplasia(BPH) and bladder stones. Methods 78 cases with BPH and bladder stones were selected as the study subjects, and they were randomly divided into two groups, 39 cases in each group. They were all treated with transurethral PKRP, on this basis, patients in the control group were treated with small incision incision, patients in the observation group were treated with TULT. The clinical effect and complications were analyzed. Results The gravel time of the observation group was (28.56±4.73)min, which was significantly shorter than that of the control group. The intraoperative blood loss in the observation group was (103.47±10.58)mL, which was significantly less than that of the control group, there were statistically significant differences between the two groups(t=6.44, 6.85, all P 0.05). The postoperative catheterization time, bladder irrigation time and hospitalization time in the observation group were (5.26±1.38)d, (1.27±0.84)d and (6.34±1.25)d, respectively, which were significantly shorter than those in the control group, the differences were statistically significant(t=7.84, 7.16, 8.01, all P 0.05). The incidence rate of complications of the observation group was 2.56%, which was significantly lower than 5.13% of the control group(χ2=2.36, P>0.05). Conclusion The clinical efficacy and adverse reactions of transurethral PKRP combined with TULT in the treatment of BPH and bladder stones has significant effect, the utility model has the advantages of simple operation, small trauma, quick recovery and less complications, it can be used as the first choice for the treatment of elderly patients with BPH and bladder stones. Key words: Prostatic hyperplasia; Transurethral resection of prostate; Lithotripsy; Urinary bladder calculi

Transurethral endoscopic submucosal en bloc dissection for nonmuscle invasive bladder cancer: A comparison study of HybridKnife-assisted versus conventional dissection technique.

The aim of this study is to compare the efficacy and safety of en bloc bladder tumor-endoscopic submucosal dissection (BT-ESD) and conventional transurethral resection of BT (TURBT) in nonmuscle invasive bladder cancer (NMIBC) patients. A retrospective cohort study was carried out in Shaanxi Provincial People's Hospital. A total of 193 eligible NMIBC (Ta/T1) patients were enrolled in this study (95 cases in BT-ESD group and 98 cases in TURBT group), between November 2013 and January 2017. The operation time, blood loss, postoperative bladder irrigation time, catheter indwelling time, hospital stay time, and complications were compared. Data were presented as median (range). Chi-squared or rank-sum test, two-way ANOVA, and Mantel-Cox (Log-Rank) test were performed using statistical software. A threshold of P < 0.05 was defined as statistically significant. The average operation time in the BT-ESD group was longer than that of in the TURBT group (40.0 [5.0, 100.0] min vs. 19.5 [3.0, 55.5] min); however, no significant longer operating time (P < 0.05) were observed in the smaller tumor (0 cm-3 cm). The postoperative bladder irrigation time, catheter indwelling time, and hospital stay in BT-ESD group were significantly shorter than that of in TURBT group (9.0 [5.0, 18.0] h, 2.5 [1.0, 4.0] d and 3.5 [2.0, 5.0] d for BT-ESD; 18.0 [12.0, 48.0] h, 3.5 [2.0, 7.0] d, and 4.5 [3.0, 8.0] d for TURBT). In addition, the BT-ESD group showed the decreased overall incidence of complications (2.1% vs. 9.2%). The univariate and multivariate analyses indicated an association between surgical option and tumor recurrence (hazard ratio = 5.624, odds ratio = 95% confidence interval = 1.582-19.991), Kaplan-Meir analysis showed significant difference in recurrence-free survival (RFS) (94.7% for ESD group vs. 78.4% for TURBT group) at 33 months. The application of the HybridKnife lead to a decrease in complications and RFS rate, which was a more safe and effective approach for NMIBC than conventional TURBT.

Safety and Efficacy of En Bloc Transurethral Resection With 1.9 µm Vela Laser for Treatment of Non–Muscle-invasive Bladder Cancer

To evaluate the safety and efficacy of 1.9 µm Vela laser in treatment of primary non-muscle-invasive bladder cancer. The data of the patients with non-muscle-invasive bladder cancer treated by either en bloc transurethral resection with 1.9 µm Vela laser (n = 26) or conventional transurethral resection of bladder tumor (n = 44) were analyzed retrospectively. The preoperative characteristics and intraoperative complications were compared in the 2 groups. Patients who were treated by 1.9 µm Vela laser obtained a higher rate of specimens meeting the requirements of pathologic assessment for tumor staging compared with the patients treated by conventional transurethral resection of bladder tumor. No obturator nerve reflex and bladder perforation occurred during surgery in the 1.9 µm Vela laser group. However, 7 patients in the conventional transurethral resection of bladder tumor group encountered obturator nerve reflex, and 3 of them encountered bladder perforation (P <.05). There were no significant differences between the 2 groups in operative duration and transfusion rate. Patients in the 1.9 µm Vela laser group had shorter postoperative continuous bladder irrigation time than that in the conventional transurethral resection of bladder tumor group. There was no significant difference in the overall recurrence rate between the 2 groups during the follow-up periods. En bloc transurethral resection with 1.9 µm Vela laser in the treatment of non-muscle-invasive bladder cancer demonstrates an advantage over conventional transurethral resection of bladder tumor in reducing intraoperative complications, improving the quality of the specimens admitted for pathologic assessment, and shortening the duration of postoperative continuous bladder irrigation.

Comparation of 2 μm laser and plasma cutting in the treatment of benign prostatic hyperplasia

Objective To investigate the curative effect of 2 μm laser in the treatment of benign prostatic hyperplasia(BPH) and to provide theoretical basis for the clinical application of the 2 μm laser. Methods A total of 98 patients with BPH were selected and divided into 2 μm laser vaporization resection group (n=50), transurethral resection of prostate(TURP, n=48). Test subjects maximum urine flow rate(Qmax), residual urine volume(PVR), quality of life score(QOL), the international prostate symptom score(IPSS) and postoperative sexual function were detected, and the bladder irrigation time, operation time, indwelling catheter time, amount of bleeding, hospitalization time and complications were observed. Results The operation time, the amount of irrigation fluid in 2 μm laser group were higher than that of TURP group. The amount of bleeding, the time of bladder irrigation, the time of indwelling catheter and hospital stays were less than that in TURP group. After 12 months follow-up, the 2 μm laser group was superior to the TURP group after the surgery (P<0.05). Conclusions TURP and 2 μm laser resection of prostate have the same curative effect in the near future, and the 2 μm laser prostate resection is more simple, safe and better than TURP operation. Key words: Prostatic Hyperplasia; Lasers; Electrosurgery

Efficacy of rociverine tablets combined with imrecoxib tablets and comfortable nursing in the control of bladder spasm after transurethral laser resection of prostate

Objective To assess the efficacy of rociverine tablets combined with imrecoxib tablets and comfortable nursing in the control of bladder spasm after transurethral laser resection of prostate. Methods According to the digital table, 120 patients who diagnosed as benign prostate hyperplasia (BPH) were randomly divided into four groups.The patients in combined drug group (group A) were administered rociverine tablets(10mg tid) and imrecoxib tablets (100mg bid) from the day of surgery to the day of catheter removal.The patients in rociverine tablets group (group B) were treated with rociverine tablets(10mg tid), and the patients in imrecoxib tablets group (group C) were administered imrecoxib (100mg bid) from the day of surgery to the day of catheter removal.The patients in group D were administered indometacin suppositories in anus when they felt pain.All patients were given comfortable nursing.The frequency and duration of bladder spasm, the time of bladder irrigation, time needed for washing solution to turn clear, and the time of catheter indwelling in the four groups were observed and compared. Results Compared with group D, group A, group B and group C all had statistically significant differences in the frequency and duration of bladder spasm, the time of bladder irrigation, time needed for washing solution to turn clear, and the time of catheter indwelling (Fa=9.469, Fb=13.443, Fc=12.157, Fd=26.609, Fe=33.717, Ff=30.524, Fg=100.836, Fh=89.985, P3 0.05). Conclusion Rociverine tablets combinined with imrecoxib tablets for the prevention and treatment of bladder spasm after transurethral laser resection of prostate was effective, which was worthy of clinic application. Key words: Transurethral resection of prostate; Laser; Nursing care; Rociverine tablets; Imrecoxib tablets

Efficacy and safety of RevoLix 2 micron continuous wave laser vaporesection in treatment for senile patients with benign prostatic hyperplasia

The clinical efficacy and safety of RevoLix 2 μm continuous wave laser vaporesection in treatment of senile patients with benign prostatic hyperplasia (BPH) were retrospective evaluated. In 291 senile patients with BPH, 213 received 2 μm continuous wave laser vaporesection (group A) and other 78 patients received transurethral resection of prostate (TURP, group B). Compared with group B the intraoperative blood loss was less, the bladder irrigation time, catheter time and hospitalization time were shorter in group A. The subjective or objective indexes were all significantly improved at 3 and 12 months after laser treatment. The improvements of international prostate symptom score (IPSS), IPSS-S, overactive bladder symptom score (OABSS) in patients of 70-79 were more marked than those of 80 or older. Patients with mild overactive bladder (OAB) had less improvement in IPSS and IPSS-S than those with moderate-severe OAB which suggest that the storage symptoms could be improved significantly by removing obstruction. Key words: Lasers therapy; Prostatic hyperplasia; Transurethral resection of prostate

Transurethral enucleation of prostate with button electrode plasmakinetic vaporization for the treatment of Benign Prostatic Hyperplasia.

Benign prostatic hyperplasia (BPH) is a common disease in aged men. In this study, we investigated the efficacy and safety of transurethral enucleation of prostate with button electrode plasmakinetic vaporization for the treatment of BPH. 60 patients diagnosed with BPH who were treated in our hospital from August to December, 2014 by enucleation with button electrode were retrospectively reviewed, and operation time, urinary catheter indwelling time, continuous bladder irrigation time, operation related complications, maximum urinary flow rate (Qmax), post-void residual urine volume (PVR), International Prostate Symptom Score (IPSS), quality of life assessment (QOL), perioperative hemoglobin and electrolytes were recorded. All the operations were completed successfully. The operation time and urinary catheter indwelling time were 45.3 ± 16.2 min and 1.72 ± 0.32 d, respectively. During the follow-up, urethral stricture (n = 1), and urinary incontinence (n = 2) were found with recovery after 1-month training. Postoperative PVR at 1, 3 and 6 months significantly decreased compared with preoperative ones (P < 0.05). IPSS, Qmax, QOL at 1, 3 and 6 months improved significantly (P < 0.05). There was no significant difference in serum hemoglobin, sodium and potassium before and after the operation. Thus, the study proved that enucleation of prostate with button electrode was efficient and safe, which was worth being recommended.

Efficacy and safety of different hemostatic drugs in transurethral resection of the prostate in elderly patients

Objective To investigate the efficacy and safety of perioperative use of different hemostatic drugs in elderly patients undergoing transurethral resection of the prostate (TURP). Methods A total of 480 elderly patients with benign prostatic hyperplasia (BPH) admitted to the Departments of Urology and Gerontology of our hospital from January 2010 to October 2014 were selected and randomly divided into 6 groups (n=80, each). Patients in all groups were given preoperative oral finasteride for 1 week, with each of the non-control groups receiving perioperative heamocoagulase agkistrodon, mangabeys hemocoagulase, reptilase, ethylenediamine diaceturate, or dicynone+ paraaminomethyl benzoic acid (PAMBA). Intraoperative bleeding, perioperative hematocrit, hemoglobin change, continuous bladder irrigation time, adverse reactions and other clinical parameters were recorded. Results Operations went smoothly with all patients. Changes in perioperative blood routine indexes, coagulation function, intraoperative bleeding volume and continuous bladder irrigation time had significant differences between the control group and the groups treated with hemostatic drugs (all P 0.05). There were significant differences in the perioperative blood routine indexes, coagulation function, intraoperative bleeding volume and continuous bladder irrigation time between the groups with and without blood coagulation enzymes (all P<0.05). Fibrinolytic responses occurred in 2 patients in the heamocoagulase agkistrodon group and were mitigated after drug withdrawal and fibrinogen infusion. Conclusions A reasonable perioperative dose of a hemostatic drug has good clinical effects in elderly patients undergoing TURP. Hemostatic drugs such as blood coagulation enzymes have certain advantages including safety over other types of hemostatic drugs, but their doses should not be too large. Key words: Prostatic hyperplasia; Transurethral resection of prostate

Comparation of different transurethral cystectomy in patients with non muscle-invasive bladder cancer

Objectives To investigate and compare the effect of different transurethral cystectomy in patients with non muscle-invasive bladder cancer(NMIBC). Methods 91 patients with NMIBC in our hospital from May 2010 to May 2013 were divided into the HOLRBT group (n=45) and TURBT group (n=46) respectively. The operative time, amount of bleeding, bladder irrigation time, catheter indwelling time, length of stay and postoperative complications were analysed. All the patients were followed up for two years. Results There was no significantly difference in the operative time between two groups (P>0.05). Statistically differences were found in the amount of bleeding, bladder irrigation time, catheter indwelling time, length of stay and incidence rate of postoperative complications between the two groups (P<0.05). There was significantly difference in recurrence rate of two years between both groups(P<0.05). Conclusions Compared with TURBT, HOLRBT has an exact curative effect on treating NMIBC and improve the prognosis, and HOLRBT is worthy of clinical popularization and application. Key words: Urinary Bladder Neoplasms; Cystectomy; Urethra

The clinical research of transurethral diode laser en bloc resection combined with gemcitabine intravesical chemotherapy for non-muscle invasive bladder tumor

Objectives To evaluate the safety and efficacy of transurethral diode laser en bloc resection combined with gemcitabine intravesical chemotherapy for the treatment of non-muscle invasive bladder tumor. Methods From July 2014 to July 2015, clinical data of 62 patients with non-muscle invasive bladder tumor were retrospectively analyzed.All patients received transurethral diode laser en bloc resection and gemcitabine intravesical chemotherapy.The operative time, intraoperative blood loss, incidence of operative complications, bladder irrigation time, days for urethral catheterization, duration of hospitalization after surgery and recurrence were recorded. Results The mean operative time was (30.5±12.8)min with less amount of blood loss, and the obturator nerve reflex, perforation, water intoxication, urinary leakage and secondary hemorrhage did not occur.The mean time of bladder irrigating was(6.15±2.33)h, the mean time of catheterization was (7.33±1.54)d and the mean time of hospitalization after surgery was(8.21±1.26)d. Patients were followed up for 6 to 18 months, with 3 cases of ectopic recurrence. Conclusions Transurethral diode laser en bloc resection combined with gemcitabine intravesical chemotherapy for the treatment of non-muscle invasive bladder tumor is safe and effective.The operation can provide accurate tumor classification and staging information, and it is worthy of wide clinical application. Key words: Urinary Bladder Neoplasms; Cystectomy; Lasers

A comparative study on the clinical effects of 1470 nm diode laser vaporization and transurethral resection of the prostate for benign prostatic hyperplasia

Objective To compare the safety and efficacy of 1 470 nm diode laser vaporization of the prostate with transurethral resection of the prostate(TURP) in patients with benign prostatic hyperplasia(BPH). Methods From July 2014 to July 2015, 82 patients diagnosed as BPH were randomly divided into two groups.Forty cases of them underwent 1 470 nm diode laser vaporization and 42 cases for TURP.The operation time, hemoglobin decrease, serum sodium decrease, bladder irrigation time, duration of bladder catheterization and postoperative complications were recorded.The international prostate symptom score(IPSS), maximum flow rate(Qmax) and post-voiding residual volume(PVR) before and after operation were compared. Results No differences were found between the two groups in basic preoperative characteristics, such as: age, prostate volume, IPSS, PVR and Qmax(P>0.05). The mean operative time in the diode laser group was (64.8±14.6) min, slightly longer than tin he TURP group((59.3±14.5) min, P>0.05). The hemoglobin decrease, the serum sodium decrease, the time of bladder irrigating and the time of catheterization of 1470 nm diode laser group were all less than that in TURP group, the differences were significant between the two groups((2.06±1.43) g/L vs.(6.07±1.68) g/L, (1.16±0.67) mmol/L vs.(4.09±3.78) mmol/L, (5.08±2.80) h vs.(25.8±12.7) h, (3.38±1.17) d vs.(4.88±1.42) d, respectively; t=-11.615, -4.845, -10.337, -5.232; P 0.05). All patients were followed up for 3-12 months, the IPSS, PVR and Qmax of 3 months after surgery in 1 470 nm diode laser group and TURP group were all improved significantly compared with that of preoperative in both groups, but no statistical differences could be found between the two groups(IPSS: F inner grouP=527.65, P<0.001; F between groups=0.099, P=0.753; F across groups=0.040, P=0.843, PVR: F inner grouP=509.57, P<0.001; F between groups=2.817, P=0.097; F across groups=1.02, P=0.315; Qmax: inner grouP=60.06, P<0.001; F between groups=0.30, P=0.585; F across groups=0.394, P=0.532). Conclusion 1 470 nm diode laser vaporization of the prostate can significantly improve the patient's lower urinary tract obstruction symptoms, which show similar short-term effects with TURP.It also has advantages of less bleeding, shorter catheter indwelling time and rapid postoperative recovery compared with TURP, suggesting that it is a safe and effective operation for BPH treatment. Key words: Benign prostatic hyperplasia; Transurethral resection of prostate; Diode laser

PD11-04 TRANSURETHRAL ENDOSCOPIC SUBMUCOSAL EN BLOT DISSECTION FOR NON-MUSCLE INVASIVE BLADDER TUMOR: A PROSPECTIVE COMPARISON STUDY OF HYBRIDKNIFE ASSISTED VERSUS CONVENTIONAL DISSECTION TECHNIQUE

INTRODUCTION AND OBJECTIVES: Endoscopic submucosal dissection (ESD), an emerging new technology, had been reported to safely, effectively and en blot dissection method for gastrointestinal epithelial tumors treatment, which maybe a better en blot desection approach for NMIBC treatment. The present study is to compare the efficacy and safety of bladder tumor-endoscopic submucosal dissection (BT-ESD) and conventional transurethral resection of bladder cancer (TURBT) in patients with non-muscle invasive bladder tumor (NMIBC). METHODS: A prospective trial was carried out in Shaanxi Provincial People’s Hospital (Shaanxi, China), 75 patients eligible suspicious NMIBC, between November 2013 and Oct 2014, were constructively enrolled in and randomized to use of either the BT-ESD (ESD Group, 38 cases) or the TURBT treatment (TURBT group, 37 cases). The operation time, blood loss, postoperative bladder irrigation time, catheter indwelling time, hospital stay, complications and 1-year tumor recurrence rate were compared between 2 groups. RESULTS: A total of 75 patients with comparable characteristics between groups were included. The ESD group showed increased average operation time than TURBT group (30.2 9.2 min v.s 15.08 6.1 min, p< 0.05), respectively, no significant difference were found in the smaller tumor (0-2cm). The postoperative bladder irrigation time, catheter indwelling time and hospital stay in BT-ESD group were significantly shorter than TURBT group (8.3 2.8h, 2.3 0.9d and 3.0 1.3d for ESD group;16.7 3.6h, 4.8 1.3d and 6.5 1.8d for TURBT group). In addition, the BT-ESD group showed decreased overall incidence of complications (7.9% v.s 18.9%, p<0.05) and 1-year tumor recurrence rate (5.3% v.s 21.6%, p < 0.05). CONCLUSIONS: We conclude that BT-ESD as a novel approach used for NMIBT appears to be a feasibly safe and applicable. Compared with conventional TURBT, BT-ESD applies an en bloc resection technique following the principles of oncologic surgery by using HybirdHnife to facilitate histopathologic assessment more accurate and reach a R0 resection. This is much critical for planning strategy of intravesical instillation, assessing prognosis and determining the protocol of follow-up, with respective potential advantages in decreasing rates of tumor recurrence and progression, and reducing socioeconomic costs. Clearly, BT-ESD appears to benefit the patients and is worth popularizing application in clinic.

Effect of the predictability care on the complications and efficacy of patients with transurethral resection of prostate

Objective To evaluate the effect of the predictability care on the complications and efficacy of patients with transurethral resection of the prostate (TURP). Methods A total of 122 patients with TURP were chosen and divided into control group (n=61) and observation group (n=61) according to the admission time. Nurses established predictability care team for patients in the observation group and they gave routine intervention (oral education) to the patients control group. The efficacy and incidence of postoperative complications, the time of postoperative bladder irrigation, the catheter indwelling time and hospital time were observed and compared between two groups. Results After the intervention, the incidence rate of postoperative complication was 18.03% in the observation group, and was lower than 39.34% in the control group; the time of operation, postoperative bladder irrigation time, the catheter indwelling time and hospital time were lower than those of the control group, and the differences were statistically significant (χ2/t=4.972, 4.006, 3.409, 3.263, 3.592; P<0.05); the scores of nursing satisfaction were higher in the observation group than those in the control group, but the scores of IPSS were lower in the observation group than that in the control group (P<0.05). Conclusions To establish predictability care team for TURP patients can significantly reduce the incidence rate of postoperative complications, and increase the clinical efficacy of treatment. It is worthy of wide promotion and application. Key words: Transurethral resection of prostate; Complication; Predictability care; Efficacy

Bipolar Button Transurethral Enucleation of Prostate in Benign Prostate Hypertrophy Treatment: A New Surgical Technique

To evaluate the safety and efficacy of transurethral bipolar enucleation with a button electrode (B-TUEP) for the treatment of bladder outlet obstruction due to benign prostatic hyperplasia. Between July 2011 and March 2012, a single surgeon performed 50 B-TUEP. Preoperative and postoperative assessments included prostate-specific antigen, International Prostate Symptoms Score (IPSS), International Index of Erectile Function-5 (IIEF-5), quality of life (QoL) index, uroflowmetry with postvoiding residual (PVR) urinary volume, and prostate volume measured by transrectal ultrasonography. Intraoperatively, we evaluated B-TUEP time (enucleation and resection time). Perioperatively, we evaluated hemoglobin dosage, bladder irrigation time, catheterization time, acute urinary retention events, length of stay, patient readmission, and any endoscopic retreatments. Three months after surgery, 82% of the patients presented a significant improvement in maximum urine flow (Qmax; P<.001). At 6 and 12months, 80% and 83.3% of patients maintained the significant improvement (P<.001). The secondary end points IPSS, QoL, IIEF-5, and PVR presented a statistically significant improvement compared with baseline values. No significant change in hemoglobin values was observed before and after surgery. Bladder irrigation time was comprised between 24 and 36hours for about 80% of patients. In one case, second-look hemostatic endoscopy was needed. Length of stay after surgery was<48hours in 88% of cases. Readmission was required for 6% of patients for hematuria, and 6months later, 2 other patients developed bladder neck contracture treated with transurethral incision of the prostate. B-TUEP using the Gyrus PK system is a rapid and safety technique with optimal outcomes.

A short-term evaluation of the safety and the efficacy of bipolar transurethral resection of the prostate in patients with a large prostate (>90 g)

ObjectiveTo evaluate the efficacy and safety of bipolar transurethral resection of the prostate (TURP) in patients with a large prostate (>90g), as a significant recent modification of TURP is the incorporation of bipolar technology, which uses the same technique as monopolar TURP but with normal saline as the irrigant. Patients and methodsForty patients with a prostate of >90g and who were considered at risk for monopolar TURP were treated by bipolar TURP. The operative duration, resection time, resected tissue weight, resection rate, resection ratio, amount of irrigation fluid used, the decrease in intraoperative haemoglobin level, haematocrit and serum sodium levels, and the blood loss were recorded. The follow-up data were analysed. ResultsThe mean (SD) operative duration was 116.3 (25.52)min, the resection time was 106.5 (25.69)min, the resected volume was 78.9 (20.58)g, the decrease in haemoglobin levels was 1.67 (0.46)g/dL, the mean serum sodium decline was 2.60 (0.68)mmol/L, and the blood loss was 532 (101.2)mL. The blood loss/g of resected tissue was 6.85 (0.70)mL. The mean (SD) postoperative bladder irrigation time was 2.0 (0.32)days, the catheterisation time was 3.25 (0.55)days and the postoperative hospital stay was 3.25 (0.55)days. ConclusionBipolar technology makes it possible to use TURP to treat patients with very large prostates and who are at risk when treated by the standard monopolar technology, with a satisfactory safety profile and with favourable efficacy.

Effect of nursing intervention on complications of patients with transurethral resection of prostate

Objective To explore the effect of nursing intervention on complications of patients with transurethral resection of prostate .Methods Eighty patients with transurethral resection of prostate were chosen and were divided into the control group and the observation group according to the random number table , each with 40 cases.The control group received the routine nursing , and the observation group received the nursing intervention .The incidence of postoperative complication , the time of postoperative bladder irrigation , the catheter indwelling time and hospital time were observed and compared between two groups .Results The incidence rate of postoperative complication was 17.5%in the observation group , and was lower than 40.0%in the control group; the time of postoperative bladder irrigation , the catheter indwelling time and hospital time were respectively （2.5 ±0.5）, （3.5 ±0.5）, （5.0 ±1.0） in the observation group, and were lower than （3.5 ±1.0）, （4.5 ±1.0）, （7.0 ±2.0） in the control group, and the differences were statistically significant （χ2/t=4.94, 2.19, 2.26, 2.39, respectively;P〈0.05）.Conclusions The effective nursing intervention during the perioperative period of transurethral resection can significantly reduce the incidence rate of postoperative complication , and increase the clinical efficacy of treatment . Key words: Nursing intervention; Transurethral resection of prostate; Postoperative complication; Efficacy

Efficacy and safety of potassium-titanyl- phosphate laser vaporization for clinically non-muscle invasive bladder cancer.

Although transurethral resection of the bladder tumor (TURBT) is still regarded as thegold standard for the treatment of clinical non-muscle invasive bladder cancer, alternative surgical options remain investigating. Our aim was to evaluate the efficacy and safety of potassium- titanyl-phosphate (KTP) laser for the treatment of primary, clinically non-muscle invasive bladder cancer compared with standard transurethral resection of bladder tumor. The data of primary non-muscle invasive bladder cancer patients treated by either KTP laser vaporization (PVB group) or TURBT were analyzed retrospectively. The preoperative conditions and intraoperative complications such as obturator nerve reflex and bladder perforation and postoperative characteristics such as catheterization time and tumor recurrence were compared. The patients' demographics and tumor characteristics in the two groups were comparable. PVB was superior to TURBT in terms of intraoperative complications such as obturator nerve reflex (P = .0289), postoperative bladder irrigation (P = .038) and postoperative catheterization time (P < .0001). Recurrence rate after PVB was also lower than that after TURBT. Our results indicated that PVB is a feasible, safe and effective alternative surgical approach for the management of primary, clinically non-muscle invasive bladder cancer, especially for those with lifetime oral taken anticoagulation medicine, with fewer perioperative complications and lower recurrence.

Holmium laser enucleation of the prostate versus transurethral resection of the prostate: a randomized clinical trial

To evaluate the efficacy and safety of holmium laser enucleation of the prostate (HoLEP) and transurethral resection of the prostate (TURP), for treatment of benign prostatic hyperplasia (BPH). A total of 164 cases of BPH were selected from patients who were hospitalized between January 2010 and December 2011. Patients had received either HoLEP or TURP treatment. Clinical data were collected from the perioperative period, 1 month after surgery, and 12 months after surgery. There was no significant difference between the two groups in the maximum urinary flow rate (Q max), postvoid residual volume (PVR), international prostate symptom score (IPSS), or quality-of-life score (QOL score) at 1 month after surgery (p = 0.56, p = 0.346, p = 0.536 and p = 0.145, respectively). However, after 12 months, patients from the HoLEP group demonstrated better scores in Qmax, PVR, IPSS, and QOL than those from the TURP group (p = 0.037, p = 0.003, p < 0.001 and p = 0.019, respectively). The two groups had comparable operation time (p = 0.105), catheterization time (p = 0.173), and length of hospital stay (p = 0.395), but were statistically different in the weight of resected prostate tissue (p < 0.001), bladder irrigation time (p < 0.001), hemoglobin levels (p = 0.011), and blood sodium levels (p = 0.002) after surgery. Compared to TURP, HoLEP was safer and had better long-term efficacy as assessed by multiple quantitative measures. Therefore, HoLEP may present a better option in the treatment of BPH.

Laparoscopic retropubic prostatectomy: initial experience

Introduction: The surgical treatment of benign prostatic hyperplasia includes transurethral resection and suprapubic prostatectomy depending on prostate volume. The laparoscopic access creates a minimally invasive alternative to conventional suprapubic prostatectomy. Objective: to assess the feasibility of the open laparoscopic technique. Patients and methods: Between June 2006 and October 2009, 15 patients underwent laparoscopic retropubic prostatectomy in the treatment of benign prostatic hyperplasia (BPH). Laparoscopic access was used as a minimally invasive alternative to open adenomectomy. Patient characteristics and prostate volume were assessed, as well as complications in the early and late perioperative and postoperative stages. Results: Mean age was 68 years (62-75 years), mean prostate weight 123 grams (70-190 grams). Time of surgery ranged from 120 to 220 minutes. Mean estimated blood loss was 450 mL and transfusion was required for one patient. Mean hospital stay was three days. Time with indwelling catheter was six days and time of bladder irrigation was of one day for all patients. Anatomicopathological studies confirmed the diagnosis of BPH in all cases. Among postoperative complications, one patient had a superficial surgical wound infec

Safety and efficacy of 120w high performance system greenlight laser vaporization for non-muscle-invasive bladder cancer

We evaluated the safety and efficacy of 120W potassium-titanyl-phosphate (KTP) laser vaporization on patients with non-muscle invasive bladder cancer compared with standard transurethral resection of bladder tumor (TUR-BT). One hundred and fifty-eight patients of non-muscle invasive bladder cancer who underwent either 120W potassium-titanyl-phosphate (KTP) laser vaporization (HPS group, n=74) or transurethral resection of the bladder tumor (TUR-BT group, n=84) were analyzed respectively. The preoperative, intraoperative and postoperative clinical data were recorded and compared in two groups. All patients were successfully treated with 120W-KTP laser vaporization or TUR-BT. No significant differences were observed in operative time, perioperative and postoperative serum sodium and hemoglobin levels between two groups. Importantly, HPS had less specific side effects of TURBT, such as obturator nerve reflex, postoperative bladder irrigation and catheterization time, which shows statistic difference significantly (p< 0.05). Recurrence rate was lower in HPS group than those in TUR-BT group. The 120W-HPS KTP laser as a safe and feasible procedure provids an alternative for the patients with non-muscle invasive bladder cancer, especially for those on anticoagulation therapy.